Posts for: July, 2014

Everyone knows that George Washington wore false teeth. Quick, now, what were our first President's dentures made of?

Did you say wood? Along with the cherry tree, that's one of the most persistent myths about the father of our country. In fact, Washington had several sets of dentures — made of gold, hippopotamus tusk, and animal teeth, among other things — but none of them were made of wood.

Washington's dental troubles were well documented, and likely caused some discomfort through much of his life. He began losing teeth at the age of 22, and had only one natural tooth remaining when he took office. (He lost that one before finishing his first term.) Portraits painted several years apart show scars on his cheeks and a decreasing distance between his nose and chin, indicating persistent dental problems.

Dentistry has come a long way in the two-and-a-half centuries since Washington began losing his teeth. Yet edentulism — the complete loss of all permanent teeth — remains a major public health issue. Did you know that 26% of U.S. adults between 65 and 74 years of age have no natural teeth remaining?

Tooth loss leads to loss of the underlying bone in the jaw, making a person seem older and more severe-looking (just look at those later portraits of Washington). But the problems associated with lost teeth aren't limited to cosmetic flaws. Individuals lacking teeth sometimes have trouble getting adequate nutrition, and may be at increased risk for systemic health disorders.

Fortunately, modern dentistry offers a number of ways that the problem of tooth loss can be overcome. One of the most common is still — you guessed it — removable dentures. Prosthetic teeth that are well-designed and properly fitted offer an attractive and practical replacement when the natural teeth can't be saved. Working together with you, our office can provide a set of dentures that feel, fit, and function normally — and look great too.

There are also some state-of-the art methods that can make wearing dentures an even better experience. For example, to increase stability and comfort, the whole lower denture can be supported with just two dental implants placed in the lower jaw. This is referred to as an implant supported overdenture. This approach eliminates the need for dental adhesives, and many people find it boosts their confidence as well.

Periodontal (gum) disease is an infectious disease that progressively weakens the attachment of supporting tissues to the teeth, including gums, ligaments and bone. If not stopped, the loss of attachment will eventually lead to bone and tooth loss.

A thin layer of plaque that builds up on teeth (mainly due to poor oral hygiene habits) is the main breeding ground for the bacteria that cause gum disease. Our main treatment goal is to remove as much of this plaque as possible from tooth and gum surfaces. Much of the plaque can be removed using special hand or ultrasonic instruments that deep clean dental surfaces, including the roots. But while effective, these manual techniques may not address the full extent of infection, especially if the disease is well advanced.

If severe bone loss has already occurred, deep pockets of infection may have developed. As bone loss progresses, teeth with multiple roots may also develop an anatomical problem known as furcation invasions where the roots of the tooth branch off. If there continues to be signs of disease, like gum inflammation, bleeding or pus formation, it’s these hard to reach areas that may still be a problem even after extensive treatment. If so, we may need to take a different approach with antimicrobial or antibiotic products.

The most effective antimicrobial substance for reducing bacteria in biofilm is a chlorhexidine mouthrinse. The typical 0.12% solution is only available by prescription — if taken for a prolonged time it can result in tooth staining, affected taste or mouth irritation. To assure the solution reaches below the gum line, it will need to be applied by us in the office, followed up flushing irrigation of the affected area.

Another alternative is topically applied antibiotics that can stop or even reverse the progression of gum disease. There’s evidence that topical applications can penetrate into these deeper areas of infection. A common antibiotic used in this way is tetracycline, which has been shown to stop inflammation and infection.

These treatments don’t eliminate the need for mechanical cleaning, and the prolonged use of antibacterial products can have a detrimental effect on “good” bacteria (needed, for example, to complete the digestive process). It will depend on the extent of the gum disease to determine how successful conservative treatment may be. It’s also important that you contribute to your own dental health with a renewed daily oral hygiene habit.